Pediatric Neurology Research in the Twenty-First Century: Status, Challenges, and Future Directions Post–COVID-19

Abstract

Background:The year 2020 marked a fundamental shift in the pediatric neurology field. An impressive positive trajectory of advances in patient care and research faced sudden global disruptions by the coronavirus disease 2019 pandemic and by an international movement protesting racial, socioeconomic, and health disparities. The disruptions revealed obstacles and fragility within the pediatric neurology research mission. However, renewed commitment offers unique opportunities for the pediatric neurology research community to enhance and prioritize research directions for the coming decades. Methods: The Research Committee of the Child Neurology Society evaluated the challenges and opportunities facing the pediatric neurology research field, including reviewing published literature, synthesizing publically available data, and conducting a survey of pediatric neurologists. Results: We identified three priority domains for the research mission: funding levels, active guidance, and reducing disparities. Funding levels: to increase funding to match the burden of pediatric neurological disease; to tailor funding mechanisms and strategies to support clinical trial efforts unique to pediatric neurology; and to support investigators across their career trajectory. Active guidance: to optimize infrastructure and strategies, to leverage novel therapeutics, enhance data collection, and improve inclusion of children in clinical trials. Reducing disparities: to reduce health disparities in children with neurological disease, to develop proactive measures to enhance workforce diversity and inclusion, and increase avenues to balance work-life obligations for investigators. Conclusions: In this uniquely challenging epoch, the pediatric neurology research community has a timely and important mission to re-engage the public and government, advancing the health of children with neurological conditions.

Severe Acute Respiratory Syndrome Coronavirus 2-Induced Neurological Complications

“…Clinicians can observe their patients with preexisting seizure disorders through regular telemedicine (Parihar et al, 2020). Moreover, because COVID-19 could cause neurological complications in children as well, pediatric neurology should pay more attention to their patients' manifestations for a timely diagnosis and treatment (Bonkowsky et al, 2020).…”

Adult Neurology Rotations for Child Neurology Residents

“…Since the formal development of organized child neurology (CN) training programs in the late 1950s, 1 monumental changes have occurred in science, diagnostics, and therapeutics in pediatric neurology. 2 While the field of CN originally emerged as a subspecialty of adult neurology, 3 pediatric neurology divisions have grown in both size of faculty and number of residents in training, and many are established within departments of pediatrics in large urban children's hospitals. 4 Reflecting these changes, the 2015 American Academy of Pediatrics and Child Neurology Society (CNS) Workforce Survey demonstrated that CN residents and practicing physicians favor an increased training emphasis on child-centric disciplines such as genetics and developmental disorders and a decrease in the amount of adult neurology training.…”

“…Since the formal development of organized child neurology (CN) training programs in the late 1950s, 1 monumental changes have occurred in science, diagnostics, and therapeutics in pediatric neurology. 2 While the field of CN originally emerged as a subspecialty of adult neurology, 3 pediatric neurology divisions have grown in both size of faculty and number of residents in training, and many are established within departments of pediatrics in large urban children's hospitals. 4…”

COVID-19 Pandemic and Child Neurology Training: A Bumpy Road Ahead

“…neurology research and the funding post COVID-19 in the developed countries. 1 We would like to address the setbacks in the training of pediatric neurology residents and fellows and research activities in the teaching hospitals from developing countries.…”